Provider Type Icon

DR. SAMUEL J. CLARK M.D. NPI 1689611709


NPI Information

NPI: 1689611709
Provider Name: DR. SAMUEL J. CLARK, M.D.
Classification: Internal Medicine - 207RP1001X
Entity Type: Individual

Specialization: Pulmonary Disease

PECOS Registration: Yes

Address:
1940 EL CAJON BLVD
SAN DIEGO, CA
ZIP 92104
Phone: (619) 543-4500
Get Directions

DR. Samuel J. Clark, M.D. is a pulmonary disease internal medicine in San Diego, CA with 32 years of experience. The provider is an internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. DR. Samuel J. Clark, M.D. NPI is 1689611709. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1992

The provider's business location address is:

1940 EL CAJON BLVD
SAN DIEGO, CA
ZIP 92104-005
Phone: (619) 543-4500
Fax: (619) 295-5600

The NPI 1689611709 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Home sleep test (hst) with type iii portable monitor, unattended; minimum of 4 channels: 2 respiratory movement/airflow, 1 ecg/heart rate and 1 oxygen saturation (HCPCS:G0399)

The enumeration date for this NPI number is 5/31/2006 and was last updated on 4/8/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineA52335CALIFORNIANo
2207RC0200XInternal MedicineCritical Care MedicineA52335CALIFORNIANo
3207RS0012XInternal MedicineSleep MedicineA52335CALIFORNIANo
4207RP1001XInternal MedicinePulmonary DiseaseA52335CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1G10892MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.